One Health Action against Human Fascioliasis in the Bolivian Altiplano: Food, Water, Housing, Behavioural Traditions, Social Aspects, and Livestock Management Linked to Disease Transmission and Infection Sources
2022
René Angles | Paola Buchon | M. Adela Valero | M. Dolores Bargues | Santiago Mas-Coma
The Northern Bolivian Altiplano is the fascioliasis endemic area with the reported highest human prevalence and intensities. A multidisciplinary One Health initiative was implemented to decrease infection/reinfection rates detected by periodic monitoring between the ongoing yearly preventive chemotherapy campaigns. Within a One Health axis, the information obtained throughout 35 years of field work on transmission foci and affected rural schools and communities/villages is analysed. Aspects linked to human infection risk are quantified, including: (1) geographical extent of the endemic area, its dynamics, municipalities affected, and its high strategic importance: (2) human population at risk, community development and mortality rates, with emphasis on problems in infancy and gender: (3) characteristics of the freshwater collections inhabited by lymnaeid snail vectors and constituting transmission foci: (4) food infection sources, including population surveys with questionnaire and reference to the most risky edible plant species: (5) water infection sources: (6) household characteristics: (7) knowledge of the inhabitants on Fasciola hepatica and the disease: (8) behavioural, traditional, social, and religious aspects: (9) livestock management. This is the widest and deepest study of this kind ever performed. Results highlight prevention and control difficulties where inhabitants follow century-old behaviours, traditions, and beliefs. Intervention priorities are proposed and discussed.
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